Colorado shooting: Ambulances were available, but many went unused

Even as Aurora police begged for ambulances at the scene of last week's theater massacre, at least six nearby medical responders weren't called to the scene for 20 to 35 minutes — or were never called at all.

The existence of unused ambulances contradicts early accounts that the injured were taken to hospitals in police cars in part because ambulances were doubled up with casualties.

The Denver Post reported Wednesday that emergency medical workers from the Aurora Fire Department arrived at theater 9 almost 24 minutes after the shooting, even though police began asking for help there 8 minutes into the crisis. Many ambulances, meanwhile, were directed by a fire commander to a nearby staging area to await further instructions, according to dispatch tapes.

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Aurora Fire Chief Mike Garcia said Thursday night he was "disappointed people are second-guessing the exceptional work" done by the firefighters, and that due to the "severely congested" scene with hundreds of cars from patrons and police, "routing ambulances to all patient locations was impossible."

"By using available ambulances and police cars, we were able to transport all on-scene patients within 55 minutes," he said in an e-mailed statement to The Post. " Our response times were outstanding and critical patients were quickly moved from the scene because fire and police worked together to use all available resources."

Whether additional ambulances would have impacted the treatment of the 58 people injured or 12 who died isn't clear. Autopsies have not been released, and a judge has issued a gag order on law enforcement agencies involved in the case.

David Patterson, division general manager of Rural/Metro Corp. which contracts with the city of Aurora to provide ambulance services, declined to discuss details about where his 14 ambulances went once they arrived on scene. However, he said, the first ambulance arrived at the shooting scene 2 minutes and 45 seconds after the 12:39 a.m. shooting call.

"We had a critically wounded patient treated and loaded into the ambulance within 11 minutes," he said.

Another 10 ambulances from other agencies also responded, although it appears many of those were dispatched later.

Cunningham Fire Protection District was not called to the scene until 20 minutes after the shooting was reported, said Chief Jerry Rhodes. He and two medical personnel arrived about 1:13 a.m.

One of the medical personnel went to the theater, and the other to the staging area.

"Clearly, most of the patients — reds and yellows — were removed from the scene by then," he said.

Denver Health was notified at 12:47 a.m. to brace for multiple victims in the emergency room. The call for ambulance assistance didn't come for another 16 minutes. South Metro Fire Rescue was called 30 minutes after the shooting was reported. Englewood Fire Department was called 35 minutes after.

Nearby private companies — American Medical Response and Action Care Ambulance Inc. — were called to back up nonrelated 911 calls but not to the scene.

"We asked Rural /Metro where they wanted us, and they said we weren't needed," said Bill Wallace, president of Action Care, who said he had four ambulances in the city of Aurora at the time.

Dr. Comilla Sasson, who was one of two ER doctors on duty at University of Colorado Hospital on Friday morning, said most of the patients who came in were brought in police cars.

She said typically, a patient in an ambulance comes into the ER after key steps are taken by the paramedic, including an IV line, if necessary, and the gathering of vital signs such as heart rate, blood pressure and whether the patient is talking coherently. But speed can be just as important, if there's not a choice of vehicles.

"At the end of the day, the fact they were able to bring patients to us quickly is why we saved 22 out of 23 people (brought to the hospital)," Sasson said.

Whether a patient is better off being treated by a medical responder or getting to the hospital as fast as possible can only be analyzed on a case-by-case basis, said Carl Schultz, director of research at the Center for Disaster Medical Sciences at University of California at Irvine.

"It all depends on the patient's injuries," he said.

At 1:25 a.m., police officers said the victims were "all gone," according to the dispatch. About 15 minutes later, another officer mentioned he found a man who was wounded with shrapnel in his face, but it was minor enough that the man didn't realize he was hurt.

Asked what to do, another officer said there were "a bunch of ambulances backed up over there" on the west side of the theater.

The Post reported Wednesday that the medical response to the shooting worked from the outside in, which meant that some critically injured patients who could not be moved had to wait. When medical help did reach them, according to the dispatch recordings, ambulances weren't at theater 9.

"FYI, right now we're loading patients into back of PD cars to get them transported," said the first fire department responder to reach the theater, according to the dispatch tapes. "Any ambos we could get would be nice."

The metro area has mutual-aid agreements among agencies that stipulate that one municipality, and its ambulance contractor, if it has one, will help another municipality in emergency situations. However, an outside agency must get permission to respond.